It is well known that the sensation of thirst is generally reduced in older adults, with one of the consequences being a tendency for fluid intake to be reduced. This can be problematic, as dehydration may have more serious adverse effects on those whose physical and mental capacities are already impaired than in younger healthy individuals.

Most geriatricians recognise that acute dehydration is often a precipitating factor in hospital admissions in the elderly. However, in the absence of thirst, it can be difficult to ensure compliance with advice to increase fluid intake. However, it is also well known that elderly patients with heart failure may be troubled by thirst.

This paper compared the intensity of thirst in patients with and without heart failure and the relationship between subjective sensations of thirst and the health-related quality of life and indices of the fluid balance. Heart failure patients reported significantly more intensive thirst (median = 75 mm) than the control group who suffered from other acute illnesses and who had the expected low values for ratings of thirst (median = 25 mm; p < 0.0001).

Overall health-related quality of life was low and was not related to thirst. Serum sodium concentration and urine colour, which are often used as markers of hydration status, did not differ significantly between the groups, but the urine of the HF patients had a lower sodium concentration and osmolality. The authors concluded that elderly patients with worsening heart failure have considerably increased thirst and, hence, intense thirst should be regarded as a symptom of heart failure.

Abstract

Elderly patients with heart failure (HF) may be troubled by thirst, despite the fact that elderly have an impaired ability to sense thirst. The present study was undertaken to compare the intensity of thirst in patients with and without HF and to evaluate how this symptom relates to the health-related quality of life and indices of the fluid balance. Forty-eight patients (mean age 80 years) admitted to hospital with worsening HF (n = 23) or with other acute illness (n = 25) graded their thirst and estimated their health-related quality of life (HRQoL). Serum sodium was measured and urine samples were assessed for color and electrolyte content. The HF patients reported significantly more intensive thirst (median = 75 mm) compared with those in the control group (median = 25 mm; p < 0.0001). There was no statistically significant relationship between thirst and HRQoL, which was low overall. Serum sodium and urine color did not differ significantly between the groups, but the urine of the HF patients had a lower sodium concentration and osmolality. We conclude that elderly patients with worsening HF have considerably increased thirst and, hence, intense thirst should be regarded as a symptom of HF.

The aim of EHI is to promote the advancement and sharing of knowledge on Human Hydration, especially amongst healthcare professionals.

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